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Synchronous or metachronous lymphoma and metastatic cutaneous squamous cell carcinoma in the head and neck region: a diagnostic and management dilemma

Published online by Cambridge University Press:  04 August 2016

I Kader*
Affiliation:
Department of Otolaryngology/ Head and Neck Surgery, Gosford, New South Wales, Australia
B Leavers
Affiliation:
Department of Otolaryngology/ Head and Neck Surgery, Gosford, New South Wales, Australia
S Shashinder
Affiliation:
Department of Otolaryngology/ Head and Neck Surgery, Gosford, New South Wales, Australia Central Coast Clinical School, University of Newcastle, Gosford, New South Wales, Australia
B Wylie
Affiliation:
Central Coast Clinical School, University of Newcastle, Gosford, New South Wales, Australia Department of Haematology, Gosford Hospital, Gosford, New South Wales, Australia
K-K Chi
Affiliation:
PRP Diagnostic Imaging, Gosford, New South Wales, Australia
P Sundaresan
Affiliation:
Sydney Medical School, University of Sydney, New South Wales, Australia
*
Address for correspondence: Dr Imran Kader, Department of Otolaryngology/ Head and Neck Surgery, Gosford Hospital, 10 Holden Street, Gosford, NSW 2250, Australia Fax: +61 2 4320 3860 E-mail: imran_kader@hotmail.com

Abstract

Objective:

To review our experience of managing patients with a dual diagnosis of metastatic cutaneous squamous cell carcinoma in the head and neck region and low-grade non-Hodgkin lymphoma. The secondary aim was to evaluate the utility of 18F-fluorodeoxyglucose positron emission tomography during diagnosis.

Methods:

Patients diagnosed with metastatic cutaneous squamous cell carcinoma of the head and neck and low-grade non-Hodgkin lymphoma, in a five-year period, were identified. Patient, tumour and treatment characteristics were identified. 18F-fluorodeoxyglucose positron emission tomography imaging was reviewed and correlated with histopathology findings.

Results:

Eight patients were identified. There was a delay in diagnosis of metastatic squamous cell carcinoma in two patients. 18F-fluorodeoxyglucose positron emission tomography differentiated metastatic squamous cell carcinoma from low-grade non-Hodgkin lymphoma with a sensitivity of 88.2 per cent and a specificity of 94.7 per cent. In 38 per cent of patients, compromises in management had to be made.

Conclusion:

The management of metastatic squamous cell carcinoma can be challenging in patients with low-grade non-Hodgkin lymphoma. 18F-fluorodeoxyglucose positron emission tomography can be useful in the diagnosis of metastatic squamous cell carcinoma in patients with low-grade non-Hodgkin lymphoma.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2016 

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